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The Direct and Indirect Cost Burden of Crohn's Disease and Ulcerative Colitis

Gibson, Teresa B. PhD; Ng, Eliza MD; Ozminkowski, Ronald J. PhD; Wang, Shaohung PhD; Burton, Wayne N. MD; Goetzel, Ron Z. PhD; Maclean, Ross MD, MBA

Journal of Occupational and Environmental Medicine: November 2008 - Volume 50 - Issue 11 - p 1261-1272
doi: 10.1097/JOM.0b013e318181b8ca
Original Articles

Objective: To estimate the direct medical and indirect (absenteeism and short-term disability) cost burden of Crohn's Disease (CD) and Ulcerative Colitis (UC).

Methods: Data were obtained from 1999 to 2005 MarketScan databases. Twelve-month expenditures for patients with CD and UC were compared to expenditures among an equal number of propensity score matched comparison group patients. Regression analysis controlled for demographics and case-mix.

Results: Annual medical expenditures were significantly higher for commercially insured CD and UC patients compared to matched comparison group patients ($18,963 vs $5300 for CD patients, $15,020 vs $4982 for UC patients, respectively, all P < 0.001). Indirect costs were also high for employed patients with these conditions.

Conclusions: CD and UC are costly diseases with a significant cost burden related to health care utilization and productivity loss.

From the Thomson Healthcare (Dr Gibson), Research Division, Ann Arbor, Mich.; Bristol-Myers Squibb (Dr Ng), Princeton, N.J.; Thomson Healthcare (Dr Ozminkowski), Ann Arbor, Mich.; Thomson Healthcare (Dr Wang), Research Division, Cambridge, Mass.; University of Illinois at Chicago (Dr Burton), Chicago, Ill.; Thomson Healthcare (Dr Goetzel), Research Division, Research Professor and Director, Institute for Health and Productivity Studies, Rollins School of Public Health, Emory University, NW Washington, D.C.; Global Outcomes Research Strategy (Dr Maclean), Bristol-Myers Squibb, Princeton, N.J.

Funded by Bristol-Myers Squibb.

Eliza Ng is currently at HIP Health Plan of New York, NY.

Ronald J. Ozminkowski is a former employee of Thomson Healthcare.

Address correspondence to: Teresa B. Gibson, PhD, Thomson Healthcare, 777 E. Eisenhower Parkway, Ann Arbor, MI 48108; E-mail:

Copyright © 2008 by the American College of Occupational and Environmental Medicine